Cholesterol, lipidology, ketogenic diets, N=1 experiments, and the future of health technology :: with Dave Feldman

In this episode of Ventures, my guest Dave Feldman (@DaveKeto) and I discuss a variety of topics related to lipids, immunology, ketogenic diets, and the future of health tech. I first came across Dave’s work when I noticed my cholesterol levels (specifically LDL-C) raised significantly when fasting and/or low-carb dieting, and I found that there is a large community of people who have noticed the same phenomenon. Dave has helped pioneer efforts to formulate hypotheses around why this might be the case, and why LDL levels in our blood may be considerably more complex than we’ve been led to believe. 

Visit https://satchel.works/@wclittle/ventures-episode-11 for more detailed notes and links to resources mentioned. 

You can watch this episode via video here. 

In this episode we cover a wide variety of topics, including: 

8:02 - Introduction to basic lipidology

12:50 - Introduction to the basic lipid panel

17:06 - What are the likely purposes of having LDL particles stick around the bloodstream in humans for a few days? 

22:06 - Description of the study where lipopolysaccharide killed mice with low LDL.

23:12 - Description of why LDL undergoes endocytosis to deliver cargo to tissues around the body. 

24:50 - Why are the antioxidant features of LDL important? 

29:47 - Further discussion on immunology and free radicals. 

32:14 - What is the purpose of oxidative stress and inflammation? 

35:37 - A conversation about statins, PCSK9 inhibitors, and drug studies in general targeted at lowering LDL-C.

42:08 - How do statins work to lower cholesterol? What is the mechanism? 

48:00 - Why does LDL-C shoot up when fasting?

50:35 - How could LDL be related to fighting COVID-19?  

52:43 - Coming back to Dave’s story, what is Dave up to now? What is his most recent N=1 experiment? 

59:29 - What are Dave’s hypotheses for the expected data for this most recent experiment?

1:00:42 - How should low-carb dieters be thinking, generally, about inflammation and LDL? How should we think about data from people who lack LDL receptors? 

1:08:05 - How should people think about the size/impact of LDL particles and their ability to “shoot holes” like beebees in vascular cell walls. 

1:16:00 - Why do we care about how/why LDL particles get on the inside vascular cell walls? What does Dave think is going on when this happens?

1:20:35 - What is Dave’s overall advice for people, at the end of the day, that are concerned about their elevated LDL-C when going on low-carb, high-fat diets? 

1:25:33 - Why are triglyceride levels typically low in people on low-carb, high-fat diets?

1:33:50 - What would Dave study right now if he had a full lab to run an experiment? 

1:35:10 - What’s causing the inflammation damage on vascular cell walls in heart disease? 

1:40:23 - What’s up with high susceptibility to electrolyte imbalances on low-carb diets? What are the mechanisms involved here? 

1:47:25 - What opportunities exist for startups considering tackling the problem of heart disease and obesity?   

1:52:49 - Where can people learn more about Dave and his work? https://cholesterolcode.com/ and https://twitter.com/daveketo and https://www.facebook.com/groups/CholesterolCode/ and https://www.facebook.com/groups/LeanMassHyperResponder/